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Related Concept Videos

Barrett Esophagus-I: Introduction01:21

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Barrett's esophagus is a medical condition where the esophageal mucosa is significantly damaged by stomach acid or other digestive fluids, often due to long-term exposure associated with gastroesophageal reflux disease (GERD). In GERD, a weakened or abnormally relaxed lower esophageal sphincter allows stomach acid to flow persistently into the esophagus.
This constant acid exposure transforms the esophagus's pink mucosal lining (stratified squamous epithelium) into a type of lining more...
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Barrett Esophagus-II: Clinical Manifestations and Management01:21

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Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
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Worldwide Esophageal Cancer Collaboration: neoadjuvant pathologic staging data.

T W Rice1, T E M R Lerut2, M B Orringer3

  • 1Cleveland Clinic, Cleveland, Ohio, USA. ricet@ccf.org.

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|October 13, 2016
PubMed
Summary
This summary is machine-generated.

Pathologic stage groupings after neoadjuvant therapy (ypTNM) for esophageal cancer have different prognostic implications than those after esophagectomy alone (pTNM). Separate ypTNM staging is recommended for improved prognostication in esophageal cancer patients.

Keywords:
cancer stagingchemotherapyprognosticationradiotherapysurvival

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Area of Science:

  • Oncology
  • Cancer Staging
  • Esophageal Cancer Research

Background:

  • Uncertainty exists regarding the prognostic implications of pathologic stage groupings after neoadjuvant therapy (ypTNM) compared to pathologic groupings after esophagectomy alone (pTNM) for esophageal cancer.
  • Accurate staging is crucial for predicting patient outcomes and guiding treatment decisions in esophageal cancer.

Purpose of the Study:

  • To compare the prognostic implications of ypTNM staging with pTNM staging in esophageal cancer.
  • To determine if current staging systems adequately reflect outcomes for patients receiving neoadjuvant therapy.

Main Methods:

  • Utilized data from the Worldwide Esophageal Cancer Collaboration (WECC) including 7,773 pathologically staged neoadjuvant patients from 33 institutions globally.
  • Collected data on patient demographics, comorbidities, cancer characteristics (histology, ypTNM stage, grade), and all-cause mortality.
  • Performed non-risk-adjusted survival analysis for ypTNM categories and compared them with historical pTNM data.

Main Results:

  • Survival for ypTNM categories was unequally depressed compared to equivalent pTNM categories, with earlier ypT categories showing greater depression.
  • Survival for ypT0-2N0M0 esophageal cancers was intermediate and similar across ypT stages, while ypN+ cancers had poor survival.
  • Significant differences in prognosis were observed between ypTNM and pTNM categories, indicating their dissimilar prognostic implications.

Conclusions:

  • Pathologic stage groupings after neoadjuvant therapy (ypTNM) for esophageal cancer are not interchangeable with those after esophagectomy alone (pTNM).
  • Separate ypTNM categories and groupings are necessary for accurate prognostication in esophageal cancer patients treated with neoadjuvant therapy.
  • These findings will inform future cancer staging manuals and guide data collection for improved esophageal cancer management.